Mental Health Rachel Warner

The Question Every Mom’s Been Asked…

by Rachel Warner MAT, ATC, LAT

Every mother experienced it at least once, and I don’t typically make absolute statements. Whether it was said by a health care provider, a friend, coworker, or a family member, every mom has heard it. 

“An insult disguised as a clinically relevant question.”

For me I was sitting in L&D for the 3rd time at 36 weeks pregnant in so much pain I swore I was going into labor this time. Literally fetal position, stabbing pain, couldn’t make it down the stairs, called 911, the whole nine yards. In walks the resident. She briefly glances at the strip, and tells me I’m not in labor followed by that condescending look. That’s when she says it, “this is your first one, isn’t it?” An insult disguised as a clinically relevant question. She could have seen that in my chart, had she bothered to look, at this point I’m convinced she hadn’t. 

“This is just ONE of my stories, and I’d be willing to bet every mother has at least one.”

She was right, it was my first child and first pregnancy. However, that fact did not eliminate my gallstones she had missed because she failed to order diagnostic imaging or the intrahepatic cholestasis of pregnancy (ICP) that nearly cost me my son and resulted in an emergency cesarean birth 2 weeks late. My inexperience did not negate my concerns for mine or my child’s health. This is just ONE of my stories, and I’d be willing to bet every mother has at least one. 

I am talking about those comments made by friends and family, medical providers, acquaintances, or even perfect strangers. The comments that plant that seed of doubt. Whether you are a first time mom or a battle test pro, it happens. It is always accompanied by a smug tone that makes you doubt all your instincts as a woman and mom-to-be. Occasionally there’s an “oh just wait” tacked on the end, or maybe a “when I had my kids”, or my absolute favorite, “oh you’ll change your mind.” 

The comments are typically well intending, but come off like a punch to the gut. Moms from the very beginning are sold some contradicting advice, “trust your gut, oh, but not about this.” But maybe, if we took steps to educate moms instead of embarrassing them, understanding them instead of questioning them and assisting them instead of opposing them, we’d have fewer women walking away with birth related trauma. 

Yes, the hormone fluctuations can send anxiety into overdrive during the antenatal and postnatal periods. Moms can at times be a bit tough to reason with, we go on the defensive. Can you blame us? America is the only developed nation with an increasing maternal mortality rate, it has more than doubled since 1987. Oh, and if you’re an African American woman, your mortality rate is 3.26 times greater than white women, according to the CDC.  

A small study of 40 mothers, by Beck, found that birth trauma is truly in the eye of the beholder. “Mothers perceived that their traumatic births often were viewed as routine by clinicians.” Other studies have gone on to confirm this finding and recommend implementing assessment and counseling strategies to determine a mothers risk of developing PTSD or other trauma related effects.  

See it isn’t just an off handed comment or necessary clinical question. It is a systematic tendency to negate a mother’s needs or concerns. Practitioners all over the world are simply doing their jobs while women are bringing life into the world. What is an emotional, sensitive, and irreplaceable moment in a woman’s life, is just another day in the office for the birth attendant. This disconnect, in my very humble opinion, leads to anxiety and discontent for mothers surrounding their antenatal, delivery, and postnatal periods. 

So what’s the solution? Ideally it would be a system to screen women to determine the most vulnerable and provide them the support they need to cope with trauma and anxiety surrounding fertility, pregnancy, delivery, and motherhood. Not just a quick questionnaire at a newborn appointment, but regular check-ins for mom by mental health professionals. It would be medical professionals that ask questions and actively listen for concerns.

So what do you do while we wait for those things to be put in place, for the broken system to improve? 

  1. Enlist your partner or another safe person to help. If you become overwhelmed by your anxiety, and moved to tears when bringing up your concerns, that’s normal. Consider discussing your concerns with a safe person prior to the appointment. They can be prepared to speak for your, or the rehearsal will make expressing your concerns easier. 
  2. Request a second opinion. This is always your right. If your health care professional is not providing the care you need, seek a second opinion from another qualified health care provider (not just your favorite mom group). 
  3. Write down your questions. If you tend to feel rushed, or suddenly forget all your questions during your appointment, write them down. Keep a running list during the weeks between appointments and bring them up when you are with your healthcare provider. If you feel rush consider sending the questions via the message system or through a nurse in the office. 
  4. Ask your OB-GYN or Midwife about local resources. Most hospitals have community groups and lactation consultants available. WIC can be a fantastic resource for those that qualify. Churches could be another source of community or support. This is a wonderful question to put out to a local online mom group.
  5. Lastly, find a village. Reach out when you are feeling anxious, alone, or just off. We all need a little help sometimes. 

Lastly, just know, whatever you’re feeling is valid. There is help out there, it is just a shame you have to look so hard for it.


Physical Health

Change your posture, change your life

by Julie Loder

In the classes I teach, one of the most profound things I witness is the life-transforming benefits of improving our posture.  By “improving posture” I am talking about strengthening the muscles that lengthen and decompress our spine against the downward pressure and force of gravity, not referring to a goal of achieving any particular spinal curvature or pelvic angle.  The number of all-too-common aches and pains that derive from compromised posture and a compressed spine that is not adequately supported by the muscles of the core and lumbo-hip complex (among others), is extensive. When the spine is not supported it can result in generic low back pain, to sciatica, bulging and herniated discs, neck stiffness, pain down the shoulders and arms, limitations on range of movement to reach, bend, and twist the spine as part of movements in daily life, and on and on.  Developing strength and coordination in the muscles that decompress our spine can be a major part of alleviating these kinds of pain.

One of the benefits of becoming more aware of our posture is actually tied to a different kind of pain and a different form of healing.  Our posture is a huge part of our identity, our personal history, and our way of relating to the world. Our current default posture – the way we automatically tend to stand, sit, and generally hold ourselves upright — is a result of the sum total collection of many of our experiences that impacted our body. Our decisions we have made about how to physically show up in our own bodies, as we introduce ourselves to and navigate the world.  

From beautiful, if physically taxing experiences such as pregnancy, having a child, and the years spent holding our baby on our hip/chest/back. Traumatic events that were beyond our control, like car accidents, surgeries, or other injuries we have sustained.  The events themselves and the physical scarring can indelibly alter the shape of our spine and body, and the way we feel.  

What about the actual deliberate decisions we have made about the way we would carry and present our body to the world?  Decisions that were also not health promoting, self-affirming and resulted in compromised posture?

I hear so many examples of these stories from participants in my classes.  A woman with pronounced rounding and severe atrophy of the muscles of the upper back, told the story of having such painful and embarrassing acne as a teenager that she spent years uncomfortably and antisocially hunched over to hide her face with her hair.  

Another participant with similar physical symptoms expressed that she had been hunching her back since before adolescence as she was very tall and had a very developed chest at an early age.  Being of a shy nature and not wanting to stick out, she hunched over during critical years of physical development and now, in her 40s, has really struggled to even regain the ability to feel or consciously activate the muscles of her upper back, which of course play a central role in our postural health.  

What about other more seemingly innocuous decisions like regularly wearing high heels to achieve a certain look, despite the foot, knee, and back pain they cause? 

These are decisions where we arguably betray our bodies and physical best interests as a result of personal shame and social pressure.  Sometimes these betrayals started in our earliest and most physically and emotionally vulnerable decades of life. Over the years we pay a steep price both physically and emotionally, as the initial betrayal becomes embedded in our muscular patterning.  It leaves a pronounced footprint in the form of aches and pains, and an outward self-presentation. It’s a non-verbal communication with the world – a posture — that is marked by this history of self-betrayal.    

When we become aware of and seek to strengthen our default posture as an adult – for all the incredible physical benefits it can yield — one of the things we are doing is simply learning about our musculature.  We are re-awakening muscles we do not regularly use, and inviting them to perform the work for which they are attached to our skeletal frame. This is a physically challenging and sometimes frustrating process, as the brain struggles to reacquaint itself with muscles and entire movement patterns. It can take a leap of faith to believe we can even begin to feel those muscles again.  It takes a great deal of persistence, patience, mental discipline and mind-body connection practice to overcome that neurological impasse and to be able to access the muscles with the brain. This is the first step in strengthening them.  

This is a physically challenging and sometimes frustrating process, as the brain struggles to reacquaint itself with muscles and entire movement patterns. It can take a leap of faith to believe we can even begin to feel those muscles again. 

-Julie Loder

At the same time, as we become aware of and do physical therapy on our default posture, and take the measures to rehabilitate it back to a healthier, more anatomically and mechanically friendly, health-supportive degree of strength, we very literally do immense emotional therapy for our spirit.  As our body changes, we uncover those old sources of shame, and we reconcile them emotionally and physically. We stand taller. We empower our bodies to move and rest without pain. We can completely change the energy we project and the impression and impact we make, and for the better, since it will come from a healed, dignified self, not one beleaguered under old hurts.  

As we embark on this important personal work and physical challenge of strengthening our posture, let us pair the patience needed to help our brains find our muscles with emotional openness and curiosity, compassion for, and love of self.